Related Experiment Video
Updated: Jun 16, 2025
In Vitro Thrombosis Test for Ventricular Assist Devices
Published on: March 21, 2025
Development and validation of a nomogram for catheter-related thrombosis prediction in children with central venous
Wangfang Xie1, Bin Xu2, Xiaofang Lou3
1Comprehensive Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, 310003, Zhejiang, China.
Insights
A new prediction model helps identify children at risk for catheter-related thrombosis (CRT) using central venous catheters (CVCs). This tool uses factors like catheter duration, sex, and underlying conditions to predict CRT risk in pediatric patients.
Area of Science:
- Pediatric Thrombosis
- Vascular Access Devices
- Clinical Prediction Models
Background:
- Catheter-related thrombosis (CRT) is a complication of central venous catheters (CVCs) in children.
- Existing risk factors for CRT in children lack predictive tools or nomograms.
- This study aimed to develop and validate a predictive model for asymptomatic CRT in pediatric patients with CVCs.
Purpose of the Study:
- To develop and validate a prediction model for asymptomatic catheter-related thrombosis (CRT) in pediatric patients with central venous catheters (CVCs).
Main Methods:
- Retrospective observational study of pediatric patients receiving CVCs.
- Inclusion criteria: consecutive patients admitted between October and December 2021.
- Development and validation of a logistic regression-based prediction model and nomogram.
Main Results:
- The study included 669 pediatric patients (553 training, 116 validation).
- Independent predictors for CRT included catheter time, male sex, congenital heart disease, postoperative status, and femoral CVC placement.
- The developed nomogram demonstrated good discrimination (AUC=0.77) and calibration in the validation set.
Conclusions:
- A novel prediction model for CRT in children with CVCs was successfully established.
- The nomogram incorporates key clinical variables and shows favorable predictive performance.
- This tool can aid in identifying pediatric patients at risk for CVC-related thrombosis.
Background:
Catheter-related thrombosis (CRT) is a thrombotic complication associated with using central venous catheters (CVCs). Although risk factors for CRT were identified in children, no nomograms or predictive tools are available for the pediatric population with CVCs. This study aimed to develop and validate a prediction model of asymptomatic CRT in children with CVCs.
Methods:
This retrospective observational study included consecutive pediatric patients who admitted to the Children's Hospital Zhejiang University School of Medicine and received CVCs between October and December 2021.
Results:
This study included 669 patients, 553 (314 males, aged 22.00 [0.36, 180.00] months, 62 with CRT) were in the training set, and 116 (62 males, aged 15.00 [1.13, 156.00] months, 16 with CRT) were in the validation set. Multivariate logistic regression showed that a catheter time of 0-3 days (OR = 0.201, 95%CI: 0.081-0.497, P = 0.001), catheter time of 4-7 days (OR = 0.412, 95%CI: 0.176-0.964, P = 0.041), male (OR = 3.976, 95%CI: 1.864-4.483, P < 0.001), congenital heart diseases (OR = 0.277, 95%CI: 0.078-0.987, P = 0.048), postoperative (OR = 0.161, 95%CI: 0.072-0.360, P < 0.001), and femoral CVC (OR = 2.451, 95%CI: 1.129-5.318, P = 0.002) were independently associated with CRT. The nomogram incorporating these variables showed relatively good discrimination (AUC = 0.77, 95%CI: [0.65, 0.90]) and calibration abilities in the validation set, and the decision curve analysis (DCA) yielded a clinical net benefit.
Conclusion:
A prediction model for CRT in children with CVC was established based on catheter time, sex, diseases, postoperative, and catheter vein. The nomogram based on logistic regression model showed favorable predictive performance.
